Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP 01246-904, Brazil.
Arch Gerontol Geriatr. 2010 Nov-Dec;51(3):295-8. doi: 10.1016/j.archger.2009.12.006. Epub 2010 Jan 21.
We aimed at evaluating the relationship of lean and fat mass to bone mass in osteoporotic postmenopausal women. We invited 65 women who were being treated at the São Paulo Hospital osteoporosis outpatients' clinic to participate. Body composition and bone mineral density (BMD) measurements were performed using Dual-energy X-ray absorptiometry methodology (DXA). The mean age and weight were 69.7±6.4 years and 56.3±7.6 kg, respectively. Accordingly to the body mass index (BMI), 52.8% were of normal weight and 47.1% of the patients were overweight. Overweight women had significantly higher bone mass. Similarly, skeletal muscle index (SMI) showed a positive effect on BMD measurements and women with sarcopenia had significantly lower BMD measurements in total femur and femoral neck. In multiple regression analysis only lean mass and age, after adjustments to fat mass and BMI, were able to predict total body bone mineral content (BMC) (R(2)=28%). Also lean mass adjusted to age and BMI were able to predict femoral neck BMD (R(2)=14%). On the other hand, none of the components of the body composition (lean mass or fat mass) contributed significantly to explaining total femur BMD and neither body composition measurements were associated with spine BMD. These findings suggest that lean mass has a relevant role in BMC and BMD measurements. In addition, lower BMI and lean mass loss (sarcopenia) is associated to lower BMC and BMD of femoral neck and total femur and possible higher risk of osteoporotic fracture.
我们旨在评估骨质疏松绝经后女性的瘦体重和脂肪量与骨量的关系。我们邀请了 65 名在圣保罗医院骨质疏松门诊接受治疗的女性参与。使用双能 X 射线吸收法（DXA）进行身体成分和骨矿物质密度（BMD）测量。平均年龄和体重分别为 69.7±6.4 岁和 56.3±7.6kg。根据体重指数（BMI），52.8%的人属于正常体重，47.1%的人超重。超重女性的骨量明显更高。同样，骨骼肌指数（SMI）对 BMD 测量有积极影响，患有肌肉减少症的女性总股骨和股骨颈的 BMD 测量值明显较低。在多元回归分析中，只有瘦体重和年龄（在调整脂肪量和 BMI 后）能够预测全身骨矿物质含量（BMC）（R²=28%）。此外，调整至年龄和 BMI 的瘦体重也能够预测股骨颈 BMD（R²=14%）。另一方面，身体成分的任何组成部分（瘦体重或脂肪量）都不能显著解释总股骨 BMD，身体成分测量也与脊柱 BMD 无关。这些发现表明，瘦体重在 BMC 和 BMD 测量中具有重要作用。此外，较低的 BMI 和瘦体重流失（肌肉减少症）与股骨颈和总股骨的 BMC 和 BMD 降低以及骨质疏松性骨折的风险增加有关。
